Plasma Therapy Could Help Athletes

PRP therapy for tendinosis showed promise in athletes with Achilles and patellar tendon issues

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Injuries that prevent athletes from exercising can be both extremely frustrating and common. Thankfully, a new treatment for a common tendon condition has shown promise.

A recent study examined 80 athletes with tendinosis who received platelet-rich plasma therapy.

After receiving these treatments, most patients saw improvements in both pain and functionality of the injured area.

"Allow your injury to heal before returning to your sport."

Led by Alice La Marra, MD, radiology resident at the University of L'Aquila in L'Aquila, Italy, this new study evaluated platelet-rich plasma (PRP) therapy.

According to the American Academy of Orthopaedic Surgeons (AAOS), in PRP therapy, blood is drawn from a patient and a process called centrifugation is used to separate blood platelets from other material in the blood, increasing the concentration of platelets. The platelets are then injected back into the patient's body, in the case of this study, using ultrasound guidance. 

AAOS explained that platelets contain proteins called growth factors that are key to the healing of injuries. It is thought that this PRP therapy might stimulate healing in an injured area — in this study, a tendon.

Tendinosis is chronic damage to a tendon, the tissue that connects muscle to bone. 

Dr. La Marra and colleagues looked at 50 athletes who had degenerative tendinosis of the Achilles tendon, which connects the calf muscle and the heel, and 30 athletes who had degenerative tendinosis of the patellar tendon, which connects the kneecap and the shin. 

The athletes were evaluated at the study's beginning through magnetic resonance imaging (MRI) and through clinical observations for both pain and functional ability of the area with tendinosis.

The athletes received three sessions of PRP therapy 21 days apart. The athletes had follow-up MRIs performed 30 days after their last treatment and one year later.

Dr. La Marra and colleagues found that in the athletes with tendinosis of the Achilles tendon, measures of pain improved by 80 percent and measures of functionality improved by 53 percent.

In the group with tendinosis of the patellar tendon, measures of pain improved by 75 percent and measures of functionality improved by 50 percent.

The MRI results showed a normalization of the MRI signal, which measures the integrity of the tissue, in 90 percent of the athletes. 

The number of participants in this study was fairly small, and further research is needed to confirm these findings. However, Dr. La Marra and colleagues concluded, "The [ultrasound]-guided PRP treatment in case of degenerative tendon diseases may increase Achilles and Patellar tendons functionality and reduce recovery times in athletes."

In an interview with dailyRx News, Daniel A. Clearfield, DO (Doctor of  Osteopathic Medicine), MS, sports medicine expert, explained the thought process behind PRP in more detail.

"PRP is a subset of prolotherapy, or 'proliferative therapy', utilizing the body's innate abilities to heal itself," explained Dr. Clearfield.

"Traditional prolotherapy uses a solution, most commonly dextrose-based, to stimulate the body's natural healing processes. PRP uses the patient's own blood, spun down to concentrate the platelet rich plasma which is rich in numerous growth factors," said Dr. Clearfield. "These injections are utilized in areas that the body has given up on healing and has laid down disorganized scar tissue which is often very painful."

According to Dr. Clearfield, both prolotherapy and PRP can be good options for people with chronic ligament or tendon injuries (like the Achilles and patellar tendinosis patients in Dr. La Marra's study), as well as some people with chronic muscle tears. Dr. Clearfield also told dailyRx News that these treatments have shown promise in clinical trials for treating knee and hip arthritis as well.

"PRP is something that is becoming more mainstream in sports medicine, and it is one of the procedures that I offer in my practice," said Dr. Clearfield. 

This study was presented December 2 at the annual meeting of the Radiological Society of North America. It is important to note that studies presented at conferences are considered preliminary until published in a peer-reviewed journal. 

No conflicts of interest were reported. 

Review Date: 
December 3, 2013
Last Updated:
December 4, 2013